orporation Long Island Crty, NY 11101 22-50 Jackson Avenue / /a. SB1062192-F1 718 EFTA01662590 1 00171 0 :UAL, A 0IILL:itg f r .414, rti tAuaciwi e .19,J tai • at 19/ (YU' •/11 If' tf t P., Jai Chock M 10000 Chick Mir 11132011 1.3 am NONE THOUSAND FOUR HUNDRED NINETY SEVEN DOLLARS si